Unknown Individual – General Practice Physician, NPI 1629032974
General Practice Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for Unknown Individual
117, Meadowbrook Circle, Daytona Beach, Volusia County, Florida, 32114, United States
DAYTONA BEACH, FL 321141164
Phone: (386) 492-3243
Fax: (386) 492-3243
Type: Mailing
Cypress Edge Drive, Palm Coast, Flagler County, Florida, 32137, United States
PALM COAST, FL 321648454
Phone:
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32114)
Loading plans...
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.